CDC Finds Epilepsy Treatment Often Inadequate

Action Points

Explain to interested patients that epileptic seizures can be prevented with regular medication.

Explain that the study found that 44% of patients with active epilepsy continued to experience seizures even though the vast majority were taking medication, probably because of inadequate adherence or physician monitoring.

ATLANTA, Aug. 7 -- About one in 100 adults in a recent survey reported active epilepsy, with nearly half not receiving adequate treatment, said CDC researchers.

Among more than 120,000 individuals in 19 states, 0.84% (95% CI 0.74% to 0.96%) had had seizures within the preceding three months or were taking anti-convulsant drugs, reported David Thurman, M.D., M.P.H., of the CDC, and colleagues in the Aug. 8 issue of Morbidity and Mortality Weekly Report.

Results from the Behavioral Risk Factor Surveillance System in 2005 also showed that 44% of patients with active epilepsy reported having recent seizures, even though more than 90% were taking medication.

And 34.9% of those with recent seizures had not seen a neurologist or epilepsy specialist in the previous year, the researchers said.

In addition, the study documented that active epilepsy is associated with a host of other health and quality-of-life problems.

"These findings suggest that adults with uncontrolled seizures may not be receiving the optimal medical treatment they need and may face substantial impairments in their daily activities," said Dr. Thurman.

In all, 1.65% of respondents (95% CI 1.52% to 1.80%) said they had taken epilepsy medication or experienced seizures at some point in their lives.

Those with active epilepsy reported that they felt mentally and physically unwell significantly more often than those with no seizure history, and had more days when their activity was limited.

For example, asked how frequently their health had interfered with daily activities in the past 30 days, the mean for respondents with active epilepsy was 8.4 days (95% CI 6.9 to 10.0), compared with 2.2 days (95% CI 2.1 to 2.3) for those without a history of epilepsy.

Respondents with active epilepsy were also significantly more likely to say they were unable to work or were unemployed, and were more likely to be divorced or widowed.

Some 31.3% (95% CI 25.6% to 37.6%) said they were too disabled to work, versus 4.9% (95% CI 4.6% to 5.1%) of respondents with no epilepsy history.

Active epilepsy was associated with lower income, with 47.7% reporting household income below $25,000, compared with 26.5% of those with no history of epilepsy.

Smoking and obesity were also more common among those with active epilepsy.

Dr. Thurman and colleagues identified several potential explanations for the apparently inadequate treatment provided to many patients with active epilepsy.

They said some health professionals may have "limited knowledge of current diagnostic and treatment standards" in epilepsy.

Compliance with treatment could be an issue, they said, because medication regimens typically involve multiple daily doses and frequently more than one drug. Among adults with a history of epilepsy, 23.7% reported cost as a barrier to seeking care from a doctor within the past year.

Inadequate or interrupted insurance coverage could also be to blame, the researchers said.

Finally, they said, patients may be unaware of helpful resources and services available to help them navigate the difficulties of epilepsy management.

Dr. Thurman and colleagues pointed out that some communities offer transportation and telemedicine programs to help people with epilepsy take advantage of healthcare and social services.

They pointed out that the study was cross-sectional and unable to determine causality. They also noted that prevalence might be underestimated because of underreporting resulting from the stigma associated with disclosing epilepsy.

Reviewed by Zalman S. Agus, MD Emeritus Professor University of Pennsylvania School of Medicine

Accessibility Statement

At MedPage Today, we are committed to ensuring that individuals with disabilities can access all of the content offered by MedPage Today through our website and other properties. If you are having trouble accessing www.medpagetoday.com, MedPageToday's mobile apps, please email legal@ziffdavis.com for assistance. Please put "ADA Inquiry" in the subject line of your email.